Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hepatocellular carcinoma (HCC), one of the most frequent tumors in the world, is included by the World Health Organization as a relevant public health problem in areas of high incidence as Africa and Southeast of Asia. In this review it will be discussed: a) the close relationship between HCC and hepatitis B virus (HBV), the more universal but not the single etiologic factor having other carcinogens and co-carcinogens involved with the origen of the tumor; b) the great variation in geographic distribution of this tumor, including that of Brazil where the incidence of HCC, including the new macroscopic classification according to the pattern of growth and general with liver cirrhosis in all countries where the tumor is diagnosed; d) some morphological aspects of HCC, including the new macroscopic classification according to the pattern of growth and general characteristics of small HCC; e) the clinical and biochemical aspects, calling attention to the evaluation of serum levels of alpha-fetoprotein, not always increased in patients with HCC, and the immage processing methods, specially ultrassonography, as methods for early diagnosis of HCC, being relevant in the follow-up of high risk patients (cirrhotics HBsAg (+]. Finally some comments are done about the therapeutic methods and perspectives of reduction in the incidence of the tumor with the use of vaccination against HBV infection.
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PMID:[Hepatocellular carcinoma]. 285 22

Hepatocellular carcinoma has a lower prevalence and presents at a later age in urban Blacks than in rural Blacks. These differences have previously been shown not to be attributable to differences in serum hepatitis B virus markers. In the present study, the average age of patients with hepatocellular carcinoma in a developing urban Black population is shown to have risen from 38.9 to 56.5 years (p less than 0.0001) over a 20-year interval, while the prevalence of co-existing cirrhosis has declined from 66 to 44% (p less than 0.05) and tissue HBsAg positivity has fallen from 44 to 17.7% (p = 0.002). The lower prevalence of tissue HBsAg in the recent patients may be explained by their older age. Macronodular cirrhosis was present in 56% of cases in the earlier period but declined to 18.9% in the later period, with micronodular cirrhosis becoming the dominant nontumor pathology (p = 0.002). Liver damage attributable to the abuse of alcohol is now found in more than half of the cases (48/90) of hepatocellular carcinoma occurring in this population. The remainder show no changes (12 cases) or show macronodular or incomplete septal cirrhosis (30 cases), presumed to be of viral origin. The latter cases are more likely to have serum markers of current hepatitis B virus infection than those with evidence of alcohol abuse. We conclude that alcohol is increasing in importance as an etiologic association of hepatocellular carcinoma in urban South African Blacks. At the same time, the prevalence of macronodular cirrhosis (and of cirrhosis as a whole) in urban patients with this tumor has declined. The reason for this decline is not known.
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PMID:Liver morphology in southern African blacks with hepatocellular carcinoma: a study within the urban environment. 298 64

Three patients with symptoms related to metastases from hepatocellular carcinoma are described. The diagnosis of the primary tumor was made at autopsy in two cases and by biopsy in one. The skeletal lesions had a lytic, expansile, and hypervascular appearance. This hypervascularity may lead to bleeding either spontaneously or following biopsy. Hepatocellular carcinoma should be included in the differential diagnosis of osteolytic, expansile, hypervascular metastases, especially when such lesions are encountered in patients with liver cirrhosis.
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PMID:Hepatocellular carcinoma with skeletal metastasis. 298 74

In a Californian institution for the mentally retarded, surveillance by autopsy of all deaths (n = 138) identified three cases of hepatocellular carcinoma. Hepatocellular carcinoma cases occurred in young (mean age = 26 years) male carriers of HBsAg and were not associated with cirrhosis. They were of the nonfibrolamellar oncocytic type and were rapidly fatal. Hepatocellular carcinoma incidence in HBsAg carriers was estimated to be 246 times greater than United States males.
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PMID:Hepatocellular carcinoma in young, mentally retarded HBsAg carriers without cirrhosis. 299 46

Hepatocellular carcinoma is rare in infancy. This report describes the first documented case of congenital hepatocellular carcinoma associated with macronodular cirrhosis.
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PMID:Hepatocellular carcinoma associated with congenital macronodular cirrhosis in a neonate. 300 40

This is the first epidemiological study of Hepatocellular Carcinoma (HCC) in the province of Bergamo, an area well-known to have a high incidence of HBsAg (9.1%) and chronic alcoholic liver disease. 72 cases of HCC (60 male, 12 female) al from the province of Bergamo and encountered in 1980-84 were subjected to an epidemiological case-control study. Analysis of the results confirmed the role of certain known Risk Factors (RF) with a prevalence of male sex (83.3%), age (mean age 63), association with live cirrhosis (79.2%) and HBsAg+ (31.9%). Such findings are in line with the Italian average found in previous studies. No difference between the sexes was found in these RF except for alcoholic abuse which was significantly higher in the males (53.3%, p less than 0.05). The case-control correlation analysis revealed no difference in the prevalence of alcohol addiction and previous HBV infection (HBV-Ab+) between the HCC (with or without cirrhosis) and the various control groups (Group A: patients with no liver pathology. Group B: patients with cirrhosis of the liver). HBsAg+ was significantly higher among HCC patients without cirrhosis (46.6%, p less than 0.001), but there was no significant difference between HCC + cirrhosis and cirrhosis alone (88%). The difference between "expected" and "observed" HCC-HBsAg+ was highly significant (p less than 0.001). The overall Relative Risk (RR) of HCC for the RF-HBsAg+ was 4.6. When divided into subgroups this gave: RR = 1 for patients with cirrhosis of the liver. RR = 11.5 for patients with no liver pathology. These data confirm the importance of current HBV infection (HBsAg+), in the province, though the presence or absence of cirrhosis probably influences its significance. The approximate incidence of HCC is 9.7%/100,000/year. Considering the limitations of data on a small monocentric study in a limited area (USSL no. 30) the figure is probably underestimated and the real incidence probably higher.
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PMID:[Primary hepatocarcinoma. Epidemiologic case-control study in the province of Bergamo]. 300 20

Hepatocellular carcinoma (HCC) in Indonesia ranks as the 9th most common of cancers. The ratio of male and female in HCC 2.5:1. HCC were found mostly in the 4th to 7th decade of life. HCC is frequently accompanied with cirrhosis and close relationship with HBV. The positivity of HBV marker is 60% in CLD and 67% in HCC. The patients usually come late to the doctors, and early detection is still a problem. Ultrasonography every 4 months and serologic test every month in CLD is recommended. Ultrasonically guided fine needle aspiration biopsy is quite promising for diagnosis and early detection of HCC.
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PMID:Epidemiology of liver cancer in Indonesia. 301 89

The liver is a segmental organ that allows resection through anatomically defined planes. The surgical management of an intrahepatic lesion, discovered either during investigation of hepatological symptoms or coincidentally, must involve an approach to investigation that carries a minimum risk and does not compromise subsequent excision of the lesion. Biopsy of an intrahepatic lesion found at laparotomy is essential, but attempts at early tissue diagnosis by percutaneous biopsy of operable tumours may lead to unnecessary morbidity and tumour spread. Preoperative studies often allow a firm pathological diagnosis to be made and ultrasonography, CT scanning and arteriography can be used to fully assess operability. Hepatocellular carcinoma (HCC) is the commonest primary liver cancer and is often found in association with cirrhosis and in patients with inadequate functional hepatic reserve. Surgical excision represents the only hope of cure for these patients and a 35% 5-year survival can be achieved by resection in the non-cirrhotic patient. Fibrolamellar HCC is less often associated with cirrhosis and is more often resectable with a better prognosis. Secondary tumours are often diffuse but about 5% of colorectal metastases are either solitary or confined to a resectable area of the liver. These tumours and secondary deposits from gastrointestinal endocrine tumours represent a small group of patients with potentially curable metastatic disease. Morbidity and mortality of operation depends on the extent of resection and the functional reserve of the liver. Local resections and resection for benign disease should carry no operative mortality. Major hepatic resection has a mortality of 3-5% and resection involving the structures at the hilus of the liver has an operative mortality of 10-12%. Liver transplantation in the management of neoplastic disease in the liver has yet to show any benefit over resectional surgery except where tumours have been discovered incidentally in the removed liver after transplantation for cirrhosis.
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PMID:Surgery of liver tumours. 303 56

Hereditary tyrosinemia is an autosomal recessive, enzymatic disorder that results in micro- and macronodular cirrhosis in early childhood. Hepatocellular carcinoma occurs in approximately one-third of affected children. We evaluated the imaging studies performed in five children with this disorder. Pathologic examination of all five of the livers revealed cirrhosis and multiple regenerating nodules; hepatocellular carcinoma was present in two of the five livers. All five patients had high-attenuation or high- and low-attenuation foci within the liver. These high-attenuation foci were not apparent as focal lesions in three of four hepatic sonograms or in one of two hepatic nuclear scans. Angiography showed tumor vascularity in one patient with a focal hepatocellular carcinoma, but was indeterminate in a second patient with severe cirrhosis and multifocal hepatocellular carcinoma. Children with cirrhosis due to tyrosinemia may develop regenerating nodules that appear as high-attenuation hepatic foci on CT scans. It is difficult to differentiate regenerating nodules from multifocal hepatocellular carcinoma in these patients.
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PMID:Hepatic regenerating nodules in hereditary tyrosinemia. 330 Feb 23

Six HBsAg negative patients with cirrhosis of the liver (CL) presented with recurrent bouts of palpable purpura in the legs due to small vessel leucocytoclastic vasculitis. In addition, all patients had renal failure, proteinuria and microhaematuria. Renal biopsy disclosed either diffuse proliferative (3 cases) or focal necrotising glomerulonephritis with crescents (2 cases). One patient had IgM-IgG mixed cryoglobulinaemia (type II). Four patients died of complications of their CL. Hepatocellular carcinoma was found in 1 case. In the patient without renal biopsy renal function improved following steroids and cyclophosphamide. The pathogenesis of this syndrome of cutaneous vasculitis with severe glomerular involvement in CL is unknown but could be immune-complex mediated.
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PMID:Renal involvement in a syndrome of vasculitis complicating HBsAg negative cirrhosis of the liver. 399 59


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